Increasing compression forces across the physis in the form of plates or staples will slow longitudinal growth.
Blount’s disease, also called tibia vara, is the most common cause of genu varum that is not physiologic. The pathoanatomy is thought to involve excessive medial pressure (eg, heavy, early walkers who are in physiologic varus alignment) that produces an osteochondrosis of the physis and adjacent epiphysis that can progress to a complete physeal bar. The Hueter-Volkmann law states that increasing compression across a growth plate leads to decreasing growth and increasing tension stimulates growth.
Sabharwal presents a Level 5 review stating that in addition to tibia vara, Blount's disease is also characterized by tibia procurvatum, internal torsion, and limb shortening. Additionally, distal femoral varus is commonly noted in the late-onset form.
Moen and Pelker performed a biomechanical investigation on bovine femora. They found that the zone of provisional calcification and the metaphysis failed when subjected to compression forces.
Illustration A shows the histologic zone of failure varies with the type of load applied to the specimens.
Sabharwal, Sanjeev. Blount disease.J Bone Joint Surg Am. 2009 Jul;91(7):1758-76
PMID:19571101 (Link to Abstract)
AAOS Comprehensive Orthopedic Review, Editor Jay Lieberman, AAOS, 2009 (Chapter 4, IV)
Moen CT, Pelker RR: Biomechanical and histological correlations in growth plate failure. J Pediatr Orthop 1984;4:180-184
PMID:6199372 (Link to Abstract)